Abstract
Outcomes of Kidney Transplantation in Scleroderma Patients: A Scientific Registry of Transplant Recipients Database Study
American journal of transplantation, Vol.26(1 Supplement), p.S27
01/2026
DOI: 10.1016/j.ajt.2025.12.071
Abstract
Background: Scleroderma is a systemic autoimmune disease that can progress to end-stage renal disease requiring renal replacement therapy. Historically, kidney transplantation in scleroderma patients was associated with poor outcomes, but contemporary results in the United States remain understudied. Methods: Adult kidney transplant recipients with scleroderma (≥18 years, 1987-2024) were identified from the Scientific Registry of Transplant Recipients database. Control groups included patients with diabetes mellitus, IgA nephropathy, and all non-scleroderma recipients. Primary outcomes were patient survival and death-censored graft survival. Results: Among 347,598 kidney transplant recipients, 399 had scleroderma. Compared with non-scleroderma patients, those with scleroderma were more likely to receive a living donor transplant (45.1% vs 34.3%, p<0.001), be female (77.9% vs 39.3%, p<0.001), be White (86.5% vs 66.8%, p=0.004), and have a lower BMI (22.9 vs 27.1, p<0.001). After adjustment for donor and recipient factors, scleroderma was associated with higher mortality compared with non-scleroderma recipients (HR 1.39, 95% CI 1.19-1.65) and IgA nephropathy (HR 2.98, 95% CI 2.48-3.58), but similar to diabetes (HR 0.81, 95% CI 0.70-0.93). Death-censored graft survival was comparable between scleroderma and non-scleroderma (HR 1.27, 95% CI 0.97-1.67) and diabetes (HR 1.07, 95% CI 0.87-1.31), but inferior to IgA nephropathy (HR 2.12, 95% CI 1.59-2.81). Recurrent disease accounted for 10.5% of graft failures in scleroderma recipients. Despite higher rates of living donor transplantation, 5-year graft failure and mortality didn’t demonstrate superior outcome in scleroderma compared to other groups (Figure 1a, b). Conclusion: Kidney transplantation in scleroderma patients remains associated with worse outcomes compared to non-scleroderma recipients, but similar to diabetics needing transplantation, despite overall improvements in kidney transplant care over the past three decades.
Details
- Title: Subtitle
- Outcomes of Kidney Transplantation in Scleroderma Patients: A Scientific Registry of Transplant Recipients Database Study
- Creators
- Shengliang He - University of IowaFarah Yasmin - Yale UniversityFrancis Wilson - Yale School of MedicineAbhishek Kumar - Yale UniversitySarat Kuppachi - University of Iowa
- Resource Type
- Abstract
- Publication Details
- American journal of transplantation, Vol.26(1 Supplement), p.S27
- DOI
- 10.1016/j.ajt.2025.12.071
- ISSN
- 1600-6135
- Publisher
- Elsevier
- Language
- English
- Date published
- 01/2026
- Academic Unit
- Stead Family Department of Pediatrics; Nephrology; Internal Medicine
- Record Identifier
- 9985130060902771
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